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Kypros Kypri

Publications and source records attributed to Kypros Kypri.

At least 19 recordsLinked to original sources
PubMed2007

Assessment may conceal therapeutic benefit: findings from a randomized controlled trial for hazardous drinking.

CONTEXT: The concept that assessment of a person's health status without subsequent intervention has beneficial effects in itself has stimulated much interest in underlying psychological mechanisms, methodological implications and its public health potential. There have, however, been few experimental studies of assessment effects. AIM: To test the hypothesis that assessment in itself produces a reduction in hazardous drinking. DESIGN AND SETTING: Two conditions (group A, leaflet only and group B, leaflet and assessment but no intervention) of a four-arm randomized controlled trial with enrollment in March-April 2003. PARTICIPANTS: A total of 975 students (17-29 years) attending a primary health-care clinic completed a web-based Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Of 599 who scored >or= 8576 consented to follow-up and were included in the full four-arm trial, of whom 293 (153 women) were assigned to groups A and B. INTERVENTION: Group A received an information leaflet at baseline. Group B received the information leaflet and 10 minutes of web-based assessment 4 weeks later. MEASUREMENTS: Drinking frequency, typical quantity, heavy episode frequency, personal problems and academic problems. FINDINGS: Baseline mean AUDIT scores were 15.0 (SD = 5.4) and 14.9 (SD = 5.0) in groups A and B, respectively. Twelve months after baseline, relative to group A, group B reported lower overall consumption (geometric means ratio 0.82, 95% CI: 0.68-0.98), fewer heavy drinking episodes (0.66, 0.47-0.91), fewer problems (0.81, 0.67-0.99) and lower AUDIT scores (beta = -1.63, -0.62 to -2.65). CONCLUSIONS: Brief assessment appeared to reduce hazardous drinking. Controlled trials that rely on assessment may therefore underestimate treatment effects. Limitations include the possibility of measurement artefact due to social desirability bias.

Adolescent↗
PubMed2006

The physical inactivity matrix: lessons from the classification of physical inactivity interventions.

Physical inactivity (PI), a leading modifiable cause of disease and injury, is endemic in industrialised nations. Although considerable research has been undertaken in this field, we lack a system to synthesise the research literature to inform policy and identify research needs. The aims of this study were to (1) develop a system to classify physical inactivity intervention studies, (2) examine the distribution of PI interventions published in the peer-reviewed health literature using the system, and (3) consider implications for future research. We developed the Physical Inactivity Matrix (PIM), with 12 intervention points, created by the intersection of two dimensions: the intervention target (individual, physical environment and social/cultural environment) and the activity focus (transport, work/school, leisure and consumer). A formal search of the health research literature identified 529 eligible studies and each was classified into one of the 12 cells of the PIM. Most studies were categorised as: individual-leisure (68%), individual-work/school (12%) or social/cultural environment-leisure (13%). Only 4% targeted the physical environment. The findings of this initial application of the PIM support the call for greater investment in policies, interventions and research that focus on the relationship between the environment and PI, and transportation in particular. There would be merit in establishing the inter-rater reliability of the PIM and applying it to a wider variety of studies, including those published in the transportation and urban planning literatures. The PIM could be a useful tool for monitoring trends in research directions and funding levels over time and across countries.

Classification↗
PubMed2006

Formative evaluation and three-month follow-up of an online personalized assessment feedback intervention for problem drinkers.

BACKGROUND: In recent years, online services for problem drinkers have been developed. This paper describes ongoing efforts to improve one of these services, the Alcohol Help Center. OBJECTIVE: This report summarizes new modules added to the Check Your Drinking (CYD) screener, a component of the Alcohol Help Center, to make the CYD screener more useful to periodic heavy drinkers, as well as to regular alcohol consumers. Participants' initial reactions to the CYD screener and the changes in their drinking habits at a three-month follow-up are presented. METHODS: The CYD screener provides a free personalized Final Report that compares the user's drinking to that of others in the general population of the same age, gender, and country of origin. Current alcohol consumption and demographic characteristics are collected as part of the CYD screening process. After users were presented with a customized Final Report, they were hot-linked to a volunteer feedback survey. The voluntary feedback survey asked about impressions of the CYD Final Report. Respondents agreeing to participate were sent a follow-up survey after three months. RESULTS: We recruited 388 volunteers (69% female) who were registered users of another free-to-consumer online eHealth service. Of the 343 respondents agreeing to participate in the three-month follow-up, 138 accessed the survey, and 97 provided complete data (participation rate = 40%; completion rate = 70%). Compared to moderate drinkers, current problem drinkers judged the Final Report to be more useful (34% vs. 69%, chi2 (1) = 41.5, P < .001) and accurate (43% vs. 76%, chi2 (1) = 36.0, P < .001). Respondents who participated in the three-month follow-up displayed reductions in drinking compared to baseline (F(4,76) = 12.2, P = .001). CONCLUSIONS: Improvements can still be made to make the CYD screener more relevant to specific populations, particularly periodic heavy drinkers. There is a need to further tailor algorithms that can present questions only relevant to specific populations. There also appears to be a need to further customize the Final Report for respondents who identify themselves as infrequent heavy drinkers. These improvements will be made, and a randomized controlled trial is planned to conduct a rigorous evaluation of the CYD screener as an intervention to help problem drinkers.

Adult↗
PubMed2006

Access to the Internet among drinkers, smokers and illicit drug users: is it a barrier to the provision of interventions on the World Wide Web?

BACKGROUND: Expanding Internet-based interventions for substance use will have little benefit if heavy substance users are unlikely to have Internet access. This paper explored whether access to the Internet was a potential barrier to the provision of services for smokers, drinkers and illicit drug users. METHODS: As part of a general population telephone survey of adults in Ontario, Canada, respondents were asked about their use of different drugs and also about their use of the Internet. RESULTS: Pack-a-day smokers were less likely (48%) to have home Internet access than non-smokers (69%), and current drinkers (73%) were more likely to have home access than abstainers (50%). These relationships remained true even after controlling for demographic characteristics. Internet access was less clearly associated with cannabis or cocaine use. CONCLUSIONS: Even though there is variation in access among smokers, drinkers and illicit drug users, the World Wide Web remains an excellent opportunity to potentially provide services for substance abusers who might never access treatment in person because, in absolute terms, the majority of substance abusers do use the Internet.

Access to Information↗
PubMed2006

Friday class and heavy alcohol use in a sample of New Zealand college students.

OBJECTIVE: This study examined the association between scheduling at least one Friday class and the pattern and levels of alcohol use and heavy drinking in a sample of New Zealand college students. METHOD: Two waves of survey data were collected from 866 college students in New Zealand in the first and second semesters of the 2000 academic year. Descriptive and regression analyses were conducted to examine the associations between scheduling Friday class in the second semester, levels of alcohol use and heavy drinking in the past month, and alcohol use on different weeknights. We hypothesized that (1) heavier-drinking students would be less likely to schedule any Friday classes, (2) having at least one Friday class would be inversely related to concurrent alcohol use and heavy drinking when adjusting for potential confounders, and (3) having Friday class would be inversely related to alcohol use and heavy drinking on Thursdays and prior week- nights. RESULTS: Analysis results supported the hypothesis that heavier- drinking students would be less likely to schedule Friday classes but did not support the hypothesis that scheduling at least one Friday class would be inversely related to concurrent alcohol use and heavy drinking when adjusting for potential confounders. Having Friday class also was not associated with typical drinking on Thursday or Friday, but having Friday class was inversely associated with Thursday as the biggest drinking day when controlling for background variables. CONCLUSIONS: Findings of this study indicate that heavier-drinking students are less likely to schedule Friday classes. Scheduling at least one Friday class may reduce the likelihood of heavy drinking on Thursdays but may have no effect on the overall levels of alcohol use and heavy drinking among college students.

Adolescent↗
PubMed2005

Minimum purchasing age for alcohol and traffic crash injuries among 15- to 19-year-olds in New Zealand.

OBJECTIVES: In 1999, New Zealand lowered the minimum purchasing age for alcohol from 20 to 18 years. We tested the hypothesis that this increased traffic crash injuries among 15- to 19-year-olds. METHODS: Poisson regression was used to compute incidence rate ratios for the after to before incidence of alcohol-involved crashes and hospitalized injuries among 18- to 19-year-olds and 15- to 17-year-olds (20- to 24-year-olds were the reference). RESULTS: Among young men, the ratio of the alcohol-involved crash rate after the law change to the period before was 12% larger (95% confidence interval [CI]=1.00, 1.25) for 18- to 19-year-olds and 14% larger (95% CI=1.01, 1.30) for 15- to 17-year-olds, relative to 20- to 24-year-olds. Among young women, the equivalent ratios were 51% larger (95% CI=1.17, 1.94) for 18- to 19-year-olds and 24% larger (95% CI=0.96, 1.59) for 15- to 17-year-olds. A similar pattern was observed for hospitalized injuries. CONCLUSIONS: Significantly more alcohol-involved crashes occurred among 15-to 19-year-olds than would have occurred had the purchase age not been reduced to 18 years. The effect size for 18- to 19-year-olds is remarkable given the legal exceptions to the pre-1999 law and its poor enforcement.

Accidents, Traffic↗
PubMed2005

Computerised screening for hazardous drinking in primary care.

INTRODUCTION: Brief interventions undertaken in primary care settings have been shown consistently to reduce hazardous drinking, but they are not commonly offered in practice. The aims were to determine the uptake by young people of an offer of screening in a primary care setting; to identify patients' drinking risk levels; and to estimate the proportion who would consent to computerised brief intervention and follow-up. METHODS: Participants were 1120 patients attending a university student health service that were invited for screening while in the waiting room. Participants were also asked for their consent to be contacted for follow-up assessment 1, 6, and 12 months later. RESULTS: 1,010 patients (90%) accepted the invitation for screening. Of these, 35 (4%) failed to complete screening, thus leaving 975 with complete Alcohol Use Disorders Identification Test (AUDIT) data. Sixty percent of women and 73% of men screened positive. Twenty-three patients (4%) eligible for intervention declined follow-up assessments. DISCUSSION: The study demonstrates that the primary care setting can be used to facilitate access via computer to a large number of individuals whose drinking is hazardous. Limitations of the study include the use of an educated segment of the population who may be more receptive to computerised screening than other groups. Strengths of the study include the high rate of participation and the naturalistic setting in which the data were collected.

Adolescent↗
PubMed2005

Episode-centred analysis of drinking to intoxication in university students.

AIMS: To demonstrate the use of an internet-based retrospective diary to measure intoxication and to describe the epidemiology of intoxication in a university community. METHODS: A probability sample of 1564 New Zealand university students completed an Internet-based survey (82% response), including a retrospective diary in which the volume consumed on each of the preceding seven days and the duration of each episode were recorded, along with the respondent's gender, weight, and their typical quantity/frequency of consumption, as a measure of tolerance. These parameters were used to compute an estimated blood alcohol concentration (EBAC) for each episode. RESULTS: Using an EBAC of 0.08 g/100 ml as a criterion for intoxication produced lower estimates of incidence than binge drinking guidelines (>40 g for women, >60 g for men), or subjective reports. EBACs of 0.08 g per cent were exceeded at least weekly by 37% of women and 39% of men. Teenage females had higher EBACs than teenage males, despite lower consumption. Intoxication was positively associated with lower age, European or Maori ethnicity relative to Asian, Pacific, or other ethnicities, and with residential halls relative to other living arrangements. Faculty of study was inconsistently related to intoxication. DISCUSSION: Frequent drinking to intoxication is normative behaviour in this population group. Of particular concern are intoxication levels in females aged 16-21 years and in males throughout their 20s. The web-based retrospective diary is a useful means of measuring intoxication by self-report. Where time permits it can be enhanced by specification of drinking locations and beverage-specific questions.

Adolescent↗
PubMed2005

'Think before you buy under-18s drink': evaluation of a community alcohol intervention.

Hazardous consumption of alcohol by teenagers is a significant public health problem in New Zealand. Concern about supply of alcohol to minors motivated 'Think before you buy under-18s drink', a campaign to reduce alcohol-related harm by discouraging inappropriate supply of alcohol by adults. Two intervention districts and a comparison district, in the South Island of New Zealand, were selected for the purpose of evaluating the campaign. Primary outcome measures were changes in the prevalence of parent supply to their teenager (13-17 years) for unsupervised drinking (SUD), and changes in the prevalence of binge drinking among teenagers. At baseline, 49% of teenagers reported a recent episode of binge drinking. SUD in the past month was reported by 36% of teenagers. Recent purchases of alcohol by under-18s were common (bottle shops: 16%; pubs/bars: 11%). In contrast to teenagers, only 2% of parents reported SUD in the past month. Levels of binge drinking decreased in all three districts. Analysis of data from 474 teenagers who completed questionnaires, at baseline and follow-up, showed decreased SUD in Ashburton and Waitaki relative to Clutha, although this was not significant (OR=0.73; 95% CI: 0.43, 1.25). Discrepancies between teenager and parent reports of SUD may be due to the latter providing a socially desirable survey response and to differences in the interpretation of what constitutes adult supervision. The lack of a significant association between changes in SUD and binge drinking may be a consequence of teenagers obtaining relatively small amounts of alcohol from their parents and larger quantities from other sources, e.g. peers (some of whom may be able to purchase alcohol legally) and from licensed premises.

Adolescent↗
PubMed2005

Drink-driving and perceptions of legally permissible alcohol use.

OBJECTIVE: The leading cause of death for young people in developed countries is road traffic crashes, a large proportion of which are attributable to drink-driving. The aims of the study were to estimate the prevalence of drink-driving and drink-riding in a sample of New Zealand university students, and to identify potential risk factors, in particular, students' perceptions of legally permissible consumption before driving. METHODS: Participants were 1,564 survey respondents (82% response, mean age = 20.5 years) who were asked to indicate whether they had driven after having "perhaps too much to drink to be able to drive safely," if they had been a passenger in a vehicle "where the driver had perhaps too much to drink to be able to drive safely," and how many standard drinks they could consume in one hour and legally drive a car. An estimated blood alcohol concentration was computed and compared with legal limits. RESULTS: Drink-driving (past four weeks) was reported by 3.4% of women and 8.4% of men. Drink-riding (past four weeks) was reported by 7.0% of women and 11.5% of men. Estimated blood alcohol concentrations from students' reports of how much they could drink in one hour and be below the legal limit of 0.08 g/ml, showed that most respondents dramatically underestimated permissible consumption; only 5.8% overestimated it. CONCLUSIONS: This may be a case where misperception of a public health message serves the public good. Further reductions in drink-driving/riding will require attention to transport needs, more visible enforcement of existing legislation, and modification of youth drinking behavior.

Accidents, Traffic↗
PubMed2005

Innovative approaches to intervention for problem drinking.

PURPOSE OF REVIEW: To critique the recent literature on telephone, correspondence-based, and computerized interventions for alcohol problems, which enhance or substitute for practitioner-delivered treatments. RECENT FINDINGS: There is an unmet need for screening, assessment and intervention for alcohol problems, in part because of the difficulty in accessing such treatment within the current health care system. Research on the efficacy of correspondence or electronic (for example Internet-based) interventions is beginning to emerge. In the period 2003-2004 we identified nine acceptability or feasibility studies of these approaches and seven efficacy trials covering a wide range of settings. These modes of intervention are acceptable to patients and the public, and with careful planning, can be implemented in a variety of settings. Treatment trials demonstrate the efficacy of these interventions in reducing hazardous drinking by university students, in delaying initiation of heavy drinking in children and adolescents, and, intriguingly, in addressing insomnia among recovering alcoholics. SUMMARY: There is strong support among potential users for alcohol interventions that employ telephone assistance, written correspondence, and the Internet. These new technologies offer the prospect of increasing the reach of interventions for problem drinking and being cost-effective alternatives or supplements to face-to-face health service delivery.

Journal Article↗
PubMed2004

An internet-based survey method for college student drinking research.

The purpose of this study was to describe and assess the utility of an Internet-based survey method for characterizing the alcohol consumption of college students. After extensive pilot research, a random sample of 1910 students aged 16-29 years was invited to complete a questionnaire, consisting of a series of web-pages linked to a relational database on a secure web-site. A branch structure allowed for tailoring of survey items by age and gender. The students received up to nine contacts, including a pre-notice letter with a token gift and an e-mail invitation (Phase 1), a reminder letter and e-mail message (Phase 2), and then telephone reminders and replacement access codes (Phase 3). Non-computer-users were offered a pen-and-paper alternative, making this a mixed-mode survey. The overall response to the survey was 82% (n = 1564). The median completion time was 16.7 min. Participants' comments showed high levels of satisfaction with the survey. Comparison of web (n = 1501) versus pen-and-paper completions (n = 63) revealed no modality effects. Technical problems addressed during the course of implementation included web-browser-operating system incompatibilities, and periodic network errors, although these resulted in little lost participation. Internet-based surveys are feasible for college student research and with carefully managed recruitment, can yield a high response.

Adolescent↗
PubMed2004

Smoking in a New Zealand university student sample.

AIMS: The aims of this study were to estimate the prevalence of smoking in the University of Otago student population, and to compare estimates with those for university students in other countries, and with other similarly aged youth in New Zealand. METHODS: In 2002, 1910 randomly selected University of Otago students were invited to complete an Internet survey, and 1564 (82%) of these students responded. RESULTS: Daily smoking was reported by 10% of both women and men. A further 10% of women and 9% of men reported occasional smoking. Daily smoking was reported by 16% of Maori women and 9% of Maori men. CONCLUSIONS: Daily smoking was uncommon among University of Otago students relative to the general New Zealand population aged 15-24 years. Moreover, rates were lower than those recorded for students in other developed countries and appear to have decreased over the last decade. Smoking among Maori women, in particular, is a priority area for intervention.

Adult↗
PubMed2004

Approaches to brief intervention for hazardous drinking in young people.

This article represents the proceedings of a symposium at the 2002 joint conference of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism in San Francisco. The chair was John B. Saunders. The focus of the symposium was on brief intervention approaches for hazardous drinking among young people. The presentations were (1) Evidence for the effectiveness of brief intervention as an approach to reducing hazardous alcohol use, by John B. Saunders; (2) College student hazardous drinking in New Zealand, the USA, UK, and Australia: implications for research, policy, and intervention, by Kypros Kypri; (3) Applications of motivational feedback on the college campus, by Scott T. Walters; (4) A population based individualized alcohol harm reduction feedback intervention: preliminary results from the college-based alcohol risk reduction (CBARR) trial, by Robert G. Laforge; and (5) Brief interventions: conclusions and future directions, by Mary E. Larimer.

Adolescent↗
PubMed2004

Assessment of nonresponse bias in an internet survey of alcohol use.

BACKGROUND: Decreasing survey response rates are a growing concern in epidemiological research, principally because prevalence estimates may be biased by selective nonresponse. Internet-based methods have the potential to yield higher-quality data with lower nonresponse rates and at a lower cost than traditional methods. Little research exists on nonresponse bias in Internet surveys of alcohol use. This investigation draws on a study of the implementation of an Internet-based alcohol survey involving a random sample of 1910 university students with a response rate of 82% (n = 1564). Our aim was to identify nonresponse bias and to quantify its effects on estimates of alcohol consumption, the incidence of alcohol-related problems, and the prevalence of hazardous drinking. METHODS: Survey nonresponse has been characterized in terms of a continuum of resistance model, in which the propensity of individuals to respond is inferred from the level of effort required to elicit a response. Two methods were used to test this model: comparison of the demographic characteristics of the target sample with those of the respondents and comparison of alcohol variables for those who responded late with those who responded early. RESULTS: The results attained with method 1 showed that bias varied as a function of gender, age, ethnicity, and living arrangement. The results attained with method 2 showed that the incidence of alcohol-related problems and hazardous drinking prevalence varied as a function of response latency. If only the early and intermediate respondents had participated, the incidence of alcohol-related problems and the prevalence of hazardous drinking would each have been underestimated by 3%. CONCLUSIONS: The findings reported here are consistent with the continuum of resistance model but show that the bias resulting from nonresponse is arguably too small to be of concern with respect to estimating consumption levels, the incidence of alcohol-related problems, and the prevalence of hazardous drinking.

Adolescent↗
PubMed2004

Web-based screening and brief intervention for hazardous drinking: a double-blind randomized controlled trial.

BACKGROUND: Strong evidence exists for the efficacy of screening and brief intervention for reducing hazardous drinking. However, problems have been highlighted with respect to its implementation in health-care systems, not least of which is a reluctance of some doctors to discuss alcohol proactively with their patients. AIMS: To determine the efficacy of a novel web-based screening and brief intervention (e-SBI) to reduce hazardous drinking. DESIGN: A double-blind randomized controlled trial. SETTING: A university student health service. PARTICIPANTS: A total of 167 students (17-26 years) were recruited in the reception area and completed a 3-minute web-based screen including the Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Of these, 112 tested positive, and 104 (52 females) who consented to follow-up were included in the trial. MEASUREMENTS: Drinking frequency, typical occasion quantity, total volume, heavy episode frequency (females > 80 g ethanol, males > 120 g ethanol), number of personal problems, an academic problems score. INTERVENTION: Participants were randomized to 10-15 minutes of web-based assessment and personalized feedback on their drinking (intervention, n = 51) or to a leaflet-only control group (n = 53). FINDINGS: Mean baseline AUDIT scores for control and intervention groups were 16.6 (SD = 6.0) and 16.6 (SD = 5.7). At 6 weeks, participants receiving e-SBI reported significantly lower total consumption (geometric mean ratio = 0.74; 95% confidence interval: 0.56-0.96), lower heavy episode frequency (0.63; 0.42-0.92) and fewer personal problems (0.70; 0.54-0.91). At 6 months personal problems remained lower (0.76; 0.60-0.97), although consumption did not differ significantly. At 6 months, academic problems were lower in the intervention group relative to controls (0.72; 0.51-1.02). CONCLUSIONS: e-SBI reduced hazardous drinking among university students, to an extent similar to that found for practitioner-delivered brief interventions in the general population. e-SBI offers promise as a strategy to reduce alcohol-related harm in a way that is non-intrusive, appealing to the target group, and capable of being incorporated into primary care. Research is required to replicate the findings, to determine the duration of intervention effects, and to investigate the mechanisms by which the intervention operates.

Adolescent↗